Lower Back Pain After Lifting: What to Do in the First 48 Hours

It happens in a second. You grab a box, a bag of salt, or a toddler, and something in your lower back grabs back. Maybe you felt a pop, or maybe it just tightened up an hour later. Now you're wondering what you did and what to do next. The first two days are a good time to calm things down and watch for warning signs.

What should you do right after hurting your back lifting?

Stop lifting, find a comfortable position, and start cold or heat. Don't try to finish the job or test your back with another lift.

According to Mayo Clinic², heavy lifting or a sudden awkward movement can strain back muscles and ligaments. That's the most common reason your back hurts after lifting. A strain can hurt a lot, but it usually heals well.

Right away:

• Set the load down and get help with the rest of the job.
• Find a position that eases the pain. Lying on your back with your knees bent, or on your side with a pillow between your knees, works for many people.
• Apply ice or a cold pack wrapped in a thin towel, for about 15 to 20 minutes.
• Notice your symptoms. Pain that stays in your back is different from pain that runs down your leg.

Learn more about the causes of lower back pain on our main back pain page.

What should you do in the first 48 hours?

Calm things down, but keep moving. According to MedlinePlus¹, stop normal physical activity only for the first few days. That helps calm symptoms and swelling. Bed rest isn't recommended¹.

Here's a simple plan many people follow:

Should you use ice or heat?

Either can help, so use what feels better. MedlinePlus¹ suggests ice for the first 48 to 72 hours, then heat. A family medicine review found heat wraps eased new back pain in the first several days⁴. It also noted that ice and heat have similar effects on pain⁴. Protect your skin with a towel either way.

Should you rest or move?

Move gently. NHS guidance³ says to stay active and keep up daily activities, and not to stay in bed for long periods. According to the same family medicine review, staying active works better than bed rest for pain and function⁴. Long bed rest can stiffen joints and weaken muscles⁴.

Gentle movement means short walks, standing up often, and changing position. It doesn't mean stretching hard or working out. MedlinePlus¹ advises skipping exercise in the first days after the pain starts.

How should you sleep?

Find the position that hurts least. Many people do well on their side with a pillow between the knees, or on their back with a pillow under the knees. Get up slowly by rolling to your side and pushing up with your arms.

Is it a pulled muscle or a disc?

Usually a pulled muscle. A strain often feels like soreness, tightness, or spasms in the lower back. It may hurt more when you bend, twist, or stand up. The pain usually stays in your back or buttock.

A disc injury is possible, too. According to the American Academy of Orthopaedic Surgeons⁵, lifting with your back instead of your legs can cause a herniated disc. So can twisting while you lift. Disc problems are more likely to send pain, numbness, or tingling down one leg, often below the knee².

Signs that point more toward a disc include:

• Pain that shoots down your leg, below the knee
• Numbness or tingling in your leg or foot
• Pain that jolts down your leg when you cough or sneeze
• Weakness in your leg or foot

Read more about a herniated disc from lifting, or how to tell a pulled muscle in your lower back from a disc problem. Either way, an exam helps sort it out.

How long does back pain from lifting last?

Most back pain improves within a few weeks with home care². NHS guidance³ says back pain usually improves within a few weeks, but it can last longer or come back.

MedlinePlus¹ suggests easing back into exercise after two to three weeks. It also advises avoiding heavy lifting and twisting for the first six weeks after the pain starts. For people with physical jobs, that may mean lighter duties for a while.

According to Mayo Clinic², see a health care professional if your pain lasts longer than a few weeks. Also get checked if it's severe and doesn't improve with rest, or spreads down your leg.

An exam can also help sooner, especially if you're unsure what you did. Your doctor listens to how it happened and what makes it better or worse. Then your doctor checks how your back and hips move, and tests strength, reflexes, and feeling in your legs. X-rays are taken only if your exam calls for them.

Care at our clinics is natural and drug-free. It may include gentle joint movement, gentle muscle work, exercise, and spinal adjustments if you want them. Your doctor explains the options, and you decide. Some plans add physical therapy at our Menomonee Falls, Waukesha, and West Allis North clinics.

When should back pain after lifting worry you?

Older adults and people with osteoporosis should take a lifting injury seriously. According to a family medicine review, heavy lifting can cause a fracture in someone with osteoporosis⁴. Long-term steroid use raises that risk⁴. See a medical doctor promptly in that case, or if your back pain comes with fever or weight loss you can't explain¹. Here's a broader list of when to worry about lower back pain.

How can you lift without hurting your back again?

Let your legs do the work and keep the load close. MedlinePlus¹ offers a few simple rules:

• Get help with objects that are too heavy or awkward.
• Spread your feet apart for a wide, steady base.
• Stand close to the object and hold it near your body.
• Bend at your knees, not your waist, and lift with your legs.
• Tighten your stomach muscles as you lift or lower.
• Keep your back straight as you stand up, and don't twist.

Mayo Clinic² adds that regular low-impact exercise, core strength, and a healthy weight can help prevent back pain. Around Milwaukee, the riskiest lifts often aren't at the gym. They're the bag of water softener salt, the snowblower that won't start, or moving a couch up a narrow stairway.

If your job involves lifting all day, see our guide to care for physical jobs. Hurt on the job? Here's when to get checked for a back injury at work. We also accept workers' compensation.

Find out what's behind your back pain

Day two is often when the worry sets in. The pain hasn't vanished, getting out of a chair takes planning, and you're not sure whether to rest or push. You just want to know what you did and how to get back to work.

We're here to help you find out. Chiropractic Company has cared for Greater Milwaukee since 1982, with 400,000+ patients, 1,400+ five-star Google reviews, and 20+ neighborhood clinics. Our doctors care for lifting injuries every week. We look for the cause of your pain, not just the symptoms. Your care is designed around your condition, your medical history, your work, and your goals. You choose your care, and you see the same doctor as it continues.

Care is natural and drug-free. Treatment begins at your second visit, or the same day in acute cases if your doctor decides it's appropriate. Some plans add physical therapy at our Menomonee Falls, Waukesha, and West Allis North clinics, or massage therapy at Hales Corners and Oconomowoc. Learn more about our lower back pain care.

We're in-network with most insurance companies and accept Medicare and auto accident claims. Eligible new patients can start with the $29 new-patient special, which includes a consultation, an exam, and X-rays if needed. *See offer terms.

Visit one of our 20+ neighborhood clinics across Greater Milwaukee: Milwaukee East, Milwaukee North, Milwaukee Third Ward, Shorewood, Glendale, Mequon, Cedarburg, Grafton, Germantown, Brookfield, Menomonee Falls, Waukesha, Oconomowoc, New Berlin, West Allis, West Allis North, Greenfield, Hales Corners, Franklin, Muskego, and Cudahy.

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